3rd International Congress on Surgery and Anesthesia
September 02 | Virtual Event
Swetha Ramani CK
SRM Medical College & Research Centre India, India
Abstract:
Tranexamic acid (TXA) is a widely used antifibrinolytic agent with a well-established safety
profile. It is routinely administered in surgical procedures with anticipated major blood loss to
reduce transfusion requirements. In obstetric practice, TXA is recommended both prophylactically
and perioperatively to manage postpartum haemorrhage and to lower maternal mortality.
Although rare, hypersensitivity reactions to TXA have been reported, but such events
remain poorly documented in obstetric surgical settings.
We describe the case of a 30-year-old woman with polycystic ovarian syndrome scheduled
for elective laparoscopic sterilization under total intravenous anaesthesia (TIVA) without muscle
relaxants. In the immediate postoperative period, following intravenous administration of
TXA, the patient developed angioedema and anaphylactic shock. She was stabilized with
three doses of intramuscular epinephrine and required a continuous epinephrine infusion
for 24 hours. Subsequently, the patient developed stress cardiomyopathy, likely related to
epinephrine use and/or the anaphylactic event, resulting in reduced cardiac contractility and
heart failure. With continuous inotropic and diuretic support, full recovery was achieved by
postoperative day six. The patient was advised to undergo skin prick or intradermal testing for
TXA sensitivity after three months.
Conclusion: Although TXA is a cornerstone therapy in the prevention and management of
surgical and obstetric haemorrhage, clinicians should remain vigilant for the possibility of hypersensitivity
reactions, including life-threatening anaphylaxis. In elective procedures where
TXA administration is anticipated, preoperative allergy testing may be considered to mitigate
the risk of life-threatening adverse events
Biography
Swetha is a Professor in the Department of Anaesthesia at SRM Medical College & Research Centre. She earned
her MD in Anaesthesiology from the prestigious Madras Medical College, graduating with a Gold Medal. With
over 17 years of clinical and academic experience, Dr. Swetha has a special interest in Paediatric and Obstetric
Anaesthesia, as well as Airway Management. She has actively contributed to the development of learning aids
and innovative anaesthetic equipment designed to simplify the teaching and practice of anaesthetic techniques.
Dr. Swetha remains deeply committed to advancing both patient care and anaesthesia education.